13.JAN.2017 5 MIN READ | 5 MIN READ

Cataract is the most common cause of blindness in the world yet many do not realise they have cataract until it causes severe vision problems.

Dr Leonard Ang, ophthalmologist practising at Mount Elizabeth Hospital, explains how modern cataract surgery can help you remove your cataract before it becomes worse.

In Singapore, more than 30% of people aged 45 and above have some degree of cataract. And by the time they reach 60-years-old, 80% have cataracts.

What is a cataract?

Cataract is a condition where the natural lens of the eye becomes cloudy and the amount of light entering the eye is thus reduced. This, in turn, leads to blurred vision.

It is a slow, progressive blurring of vision – both distant and near. Things appear less bright so your vision tends to be worse at night. You may also experience glares and haloes. A continued change in spectacle power may signify the progression of the cataract.

Because the symptoms are gradual and painless, many do not realise they have cataract until it becomes very advanced. As such, they end up undergoing cataract surgery when it becomes too late.

When the cataract is very advanced, complications may develop and the lens can become more unstable. Surgery would then significantly increase the risk of complications and reduce the success rate. The recovery is much longer and the visual result is likely to be poorer.

Hence, patients are advised not to delay cataract removal surgery.

How to treat cataracts?

Surgery is the only method to treat cataracts.

Cataract surgery is recommended if the cataract is impairing vision and affecting one’s daily activities. Cataracts may also need to be removed if it is very dense and is likely to cause complications such as glaucoma. In severe cases of glaucoma, patients may lose their vision permanently.

Cataract surgery is now very advanced and can be performed as a day surgery under 30 minutes, and the patient can return home after the surgery.

The modern method of removing a cataract is by phacoemulsification, which involves making a small incision at the edge of the cornea to soften and remove the cataract. The use of femtosecond lasers could make more precise incisions, create the central opening that holds the lens, and make cracks to allow easier removal of the cataract. An artificial lens (intraocular lens) is implanted immediately following the cataract removal and the wound often seals on its own without the need for stitches.

Advances in intraocular lens technology improved visual outcomes according to each patient’s needs. This includes giving patients better vision, quality of life and greater convenience without the need for spectacles. All forms of refractive error in the eye can be corrected, including myopia (shortsightedness), astigmatism and presbyopia.

The final choice of lens is dependent on many factors including the condition of the eye, pre-existing diseases, etc. It is therefore important that the patient consults an experienced doctor to assess the suitability of the eye for the various lenses, and to determine which type of lens is most suitable for that patient.

With modern cataract surgery, there is minimal discomfort after surgery. The eye is not red. The recovery is relatively fast and patients can resume most of their regular activities within a few weeks of the surgery. If necessary, the patient can have a pair of glasses prescribed for them within 1 month.

In a nutshell

As many do not realise they have cataracts until it is very late, it would be wise to undergo regular eye screening with an eye specialist for those above 45 years of age. This can help to pick up cataract, as well as other potentially blinding eye conditions, earlier so that treatment can be promptly carried out to prevent visual loss.

Advances in cataract surgery have made the surgery extremely safe and effective. Patients are able to enjoy better vision and better quality of life. Patient should seek advice from an experienced surgeon who will be able to best advise what the most appropriate treatment is.

Ang Pek Kiang Leonard
Mount Elizabeth Hospital

Dr Leonard Ang is an ophthalmologist practising at Mount Elizabeth Hospital, Singapore. He specialises in cataract surgery, cornea disease treatment, cornea transplantation, glaucoma treatment, retinal disease treatment, stem cell transplantation, and refractive surgery (LASIK, Epi-LASIK, Implantable Contact Lens).